Cases reported "Tongue Diseases"

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1/55. lingual thyroid gland: clinical evaluation and comprehensive management.

    Although lingual thyroid gland is the most common benign mass found at the junction of the anterior two-thirds and the posterior one-third of the tongue, it is still a rare clinical entity. This developmental anomaly is the result of an arrested descent of the gland anlage early in the course of embryogenesis. patients may have symptoms of dysphagia due to obstruction or even hemorrhage. These symptoms can occur at any time from infancy through adulthood. The clinical findings, laboratory tests, and radiographic imaging studies employed in confirming the diagnosis and in planning appropriate treatment have been evaluated. The primary therapeutic goal is to restore thyroid function. We describe a case of lingual thyroid gland and summarize the current management principles for this condition.
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ranking = 1
keywords = obstruction
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2/55. Functional airway obstruction mimicking tongue angioedema.

    BACKGROUND: Functional causes of upper airway obstruction have focused primarily on psychogenic stridor associated with paradoxical vocal cord dysfunction. angioedema can involve upper airway structures and be life-threatening. CASE REPORT: We report a 12-year-old female with upper airway obstruction from posterior tongue swelling which was determined to be a conversion reaction. methods & RESULTS: A lateral neck film revealed severe tongue swelling. Examination revealed a calm, cooperative patient in no distress but exhibiting inspiratory and expiratory stridor. A computed tomography scan revealed soft tissue fullness at the base of the tongue without associated lymphadenopathy. Laboratory evaluation was normal. With anesthetic induction in the operating room, there was complete relaxation of the upper airway with no evidence of tongue swelling, mass, or other abnormality. Following tongue biopsy, she had no reoccurrence of the tongue mass. CONCLUSION: This case represents a childhood conversion reaction of functional airway obstruction where tongue manipulation simulated tongue swelling radiographically consistent with angioedema.
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ranking = 402.86682014783
keywords = airway obstruction, airway, obstruction
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3/55. Massive postoperative swelling of the tongue: manual decompression and tactile intubation as a life-saving measure.

    Massive swelling of the tongue due to haemorrhage is a rare but potentially fatal complication secondary to trauma, surgery, tumour invasion or uncontrolled anticoagulant therapy. This article presents a report of bleeding from the left lingual artery secondary to elective excision of a lipoma of the floor of the mouth and subsequent life-threatening upper airway obstruction. In this case, the upper airway obstruction was managed by manual decompression of the tongue and tactile nasal intubation. To our knowledge this case provides the first description of using this method in life-threatening upper airway obstruction caused by massive haemorrhagic swelling of the tongue.
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ranking = 169.57333725352
keywords = airway obstruction, airway, obstruction
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4/55. Lingual haematoma: yet another unusual cause of upper airway obstruction.

    An episode of acute upper airway obstruction was caused by a lingual haematoma, when a patient with end stage renal failure suffered a hypocalcaemic fit and bit his tongue. The large haematoma and profuse bleeding caused the patient to obstruct and become hypoxic, and rendered laryngoscopy and intubation impossible, requiring an urgent tracheostomy to secure the airway.
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ranking = 286.22007870068
keywords = airway obstruction, airway, obstruction
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5/55. Swelling and cyanosis of the tongue associated with use of a laryngeal mask airway.

    We present a case report of a patient who developed acute swelling of the tongue during anaesthesia using the laryngeal mask airway. The swelling was thought to be due to obstruction of the venous drainage of the tongue. This was associated with isolated cyanosis of the tongue and paraesthesia. The swelling and cyanosis of the tongue resolved rapidly after removal of the laryngeal mask airway. The patient suffered paraesthesia of the tip of the tongue that lasted for two weeks.
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ranking = 22.587099668842
keywords = airway, obstruction
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6/55. Breath-holding-like spells in an infant: an unusual presentation of lingual thyroglossal duct cyst.

    The authors report the case of an infant with a lingual thyroglossal duct cyst who presented with breath-holding-like spells, which actually represented life-threatening ball-valve obstruction of the larynx, leading to hypoxemia and transient cerebral dysfunction. When evaluating apparent breath-holding spells in young infants, physicians should include dynamic, episodic upper airway obstruction in the differential diagnosis.
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ranking = 57.524445751174
keywords = airway obstruction, airway, obstruction
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7/55. lingual thyroid--a threat to the airway.

    The occurrence of a thyroid gland superficially placed on the pharyngeal portion of the tongue is rare, but poses problems to the patient and anaesthetist. This report describes a patient with a lingual thyroid and a history of problems associated with it that resulted in admission to the ICU and warnings about future intubation of the larynx. The patient underwent awake tracheal intubation using a standard fibreoptic assisted technique, and was advised that she purchase an appropriate Medic-Alert bracelet.
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ranking = 14.391399779228
keywords = airway
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8/55. quinine induced coagulopathy--a near fatal experience.

    A 67 year old man presented to his local dentist for restorative treatment. He stated he was fit and well and denied taking any medications. When he was given an inferior alveolar nerve block, excessive bleeding was noted at the injection site and the dentist advised the patient see an oral and maxillofacial surgeon. An appointment was made for the patient but he did not attend. Three days later, he presented with evidence of massive deep haemorrhage to the point of airway compromise. He underwent hospital admission, early intubation, intensive care for nine days and hospitalization for six weeks. The cause of his bleeding was a severe thrombocytopoaenia, induced by chronic ingestion of quinine. He was self-medicating with this to relieve muscular cramps. Despite this experience, the patient continued to deny that quinine was the cause of his problem and that he had failed in his obligations to advise the dentist of his drug history. dentists need to be alert to the risk that patients may not reveal their true medical history. There are, however, obligations on the dentist to ensure the accuracy of information the patient gives and to ensure that patients whom they believe are at risk follow their advice. Teamwork and skillful airway management prevented this patient's demise.
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ranking = 7.1956998896139
keywords = airway
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9/55. life-threatening upper airway edema caused by a distal rattlesnake bite.

    A 36-year-old man captured a timber rattlesnake and was accidentally envenomated in the thumb by the severed head. At a local emergency department, hypotension and confusion developed. Facial and glossal edema were also observed. oxygen was delivered by face mask, and crystalloids and dopamine were administered. Respiratory distress developed with progressive hypoxemia. intubation was unsuccessful because of massive glossal and epiglottic (laryngeal) edema, and an emergency cricothyrotomy was performed. High-dose antivenom therapy was administered, and mechanical ventilation was started. Recovery was rapid, and the patient was discharged from the hospital a week later. This is the first report of life-threatening upper airway edema caused by snake envenomation not in the vicinity of the head or neck.
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ranking = 17.989249724035
keywords = airway
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10/55. lingual thyroid: iodine 131: a viable treatment modality revisited.

    PURPOSE: lingual thyroid has a reported incidence between 1:10 and 1:100,000. When symptomatic, patients may present with dysphagia, choking, and/or dyspnea. Current surgical treatment options range from tumor extirpation or transposition to excision and reimplantation. Tracheotomies are often performed postoperatively for reliable airway control. iodine 131 (131I) has not been a popular modality of treatment for lingual thyroid because of theoretical fears of increased airway obstruction from thyroiditis. We believe that these fears were not substantiated, and that symptomatic patients needed a reliable, nonsurgical treatment option. Therefore, our goal was to further investigate the use of 131I for the treatment of symptomatic lingual thyroid. patients AND methods: A 6-year retrospective chart review was performed. From 1994 to 2000, 2 patients with symptomatic lingual thyroid presented to the arkansas Cancer research Center head and neck Oncology clinic, University of arkansas for Medical Sciences, Little Rock, AR. patients underwent pretreatment computed tomography, and iodine 123 scans. They then received 1 oral dose of 131I. Doses ranged from 30 to 85 mCi. patients were then followed daily for signs of airway compromise. RESULTS: Complete resolution of symptoms was seen 2 months after treatment. patients did not complain of any increased airway compromise during treatment initiation. patients remain symptom-free and are maintained on thyroid hormone replacement. CONCLUSIONS: iodine 131 ablation of lingual thyroid is a safe and effective treatment in symptomatic patients and should be included in the algorithm when formulating a treatment plan.
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ranking = 67.317995585595
keywords = airway obstruction, airway, obstruction
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